Can a patient chart that has been electronically scanned into a hospital’s EMR system be used for research monitoring purposes without any additional documentation from the hospital?

No. These files are considered shadow files, and they can be kept in study records; however; if the FDA conducts a bioresearch monitoring inspection of the study, the FDA investigator will expect to review at least a portion of the original source documents to verify the authenticity of the shadow files, even if the copies in the shadow files are certified (from 2013). Documentation in the Florence Library of FDA eRegulatory and eSource Guidance

What are the requirements for sites scanning in documents and sending them to us electronically?

There are no clear requirements, but you should have a SOP for sites to have consistency in reporting/recording data. If you are not replacing the original documents, you don’t need to certify each copy, but you might want to verify the information matches what is at the site. If you want to go fully electronic, you need to make certify copies that are at least spot-checked by monitors/auditors to make sure that they are complete (from 2016). Documentation in the Florence Library of FDA eRegulatory and eSource Guidance

Can hard copies that have been scanned and double verified to ensure that they have been scanned correctly be destroyed?

When documents are printed out from an electronic system or when scanning a document does the person who makes the copy need to sign/initial and date the copy to indicate it meets the requirements of a certified copy?